A Novel Framework for the Optimization of Simultaneous ThermoBrachyTherapy

Cancers

Rob M. C. Mestrom¹  Inger-Karine K. Kolkman-Deurloo²  Miranda E. M. C. Christianen²  Gerard C. van Rhoon²  Ioannis Androulakis² 

[1] Department of Electrical Engineering, Eindhoven University of Technology, 5600 Eindhoven, The Netherlands;Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, 3015 Rotterdam, The Netherlands;

关键词: hyperthermia;    induced;    brachytherapy;    prostatic neoplasms;    interstitial hyperthermia;    treatment plan optimization;   

DOI  :  10.3390/cancers14061425

来源: DOAJ

【 摘 要 】

In high-dose-rate brachytherapy (HDR-BT) for prostate cancer treatment, interstitial hyperthermia (IHT) is applied to sensitize the tumor to the radiation (RT) dose, aiming at a more efficient treatment. Simultaneous application of HDR-BT and IHT is anticipated to provide maximum radiosensitization of the tumor. With this rationale, the ThermoBrachyTherapy applicators have been designed and developed, enabling simultaneous irradiation and heating. In this research, we present a method to optimize the three-dimensional temperature distribution for simultaneous HDR-BT and IHT based on the resulting equivalent physical dose (EQD_phys) of the combined treatment. First, the temperature resulting from each electrode is precomputed. Then, for a given set of electrode settings and a precomputed radiation dose, the EQD_phys is calculated based on the temperature-dependent linear-quadratic model. Finally, the optimum set of electrode settings is found through an optimization algorithm. The method is applied on implant geometries and anatomical data of 10 previously irradiated patients, using reported thermoradiobiological parameters and physical doses. We found that an equal equivalent dose coverage of the target can be achieved with a physical RT dose reduction of 20% together with a significantly lower EQD_phys to the organs at risk (p-value < 0.001), even in the least favorable scenarios. As a result, simultaneous ThermoBrachyTherapy could lead to a relevant therapeutic benefit for patients with prostate cancer.

【 授权许可】

Unknown